Discrimination Of Tuberculous Spondylitis From Pyogenic Spondylitis On MRI

Objective :To assess magnetic resonance imaging features in differentiating pyogenic spondylitis( PS) from tuberculous spondylitis (TBS).Material and Methods: 12 patients with tuberculous spondylitis and 6 patients with pyogenic spondylitis were investigated retrospectively. The MRI findings in both TBS and PS was compared regarding the following factors: involved spine segment(cervical, thoracic, lumbar or sacrae),extent of spinal destruction, signal intensity, paravertebral abscess formation, thickness and contour of the abscess wall,appendage involvement of the vertebral body. Statistical analysis was performed with the chisquaretest.Results: The incidence of the following MRI findings had significant differences in patients with pyogenic spondylitis than in those with tuberculous spondylitis ( P < 0.05): thoracic spinal involvement(25% in tuberculous vs 0 in pyogenic); lumbar spinal involvement(42.42% vs 82.33%) ; destructive lesions of the vertebral body and vertebral collapse (75% vs 16.67%) ; thin and smooth abscess wall 66.67% vs 16.67%).Conclusion : Magnetic resonance imaging is aery helpful for differentiation of pyogenic spondylitis from tuberculous spondylitis. Thoracic spinal involvement, markedly destructive lesion of the vertebral body, vertebral body collapse and thin smooth walled abscess were incidentive of TBS other than PS.